Healthcare Provider Details

I. General information

NPI: 1679407068
Provider Name (Legal Business Name): TRUE NORTH FAMILY CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

471 HIGHWAY 23
FOLEY MN
56329-9145
US

IV. Provider business mailing address

471 HIGHWAY 23
FOLEY MN
56329-9145
US

V. Phone/Fax

Practice location:
  • Phone: 320-968-7234
  • Fax: 320-968-7237
Mailing address:
  • Phone: 320-968-7234
  • Fax: 320-968-7237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SHANA NELSON
Title or Position: OWNER/ PROVIDER
Credential: FNP
Phone: 320-968-7234